Increased utilization of existing childhood vaccines against measles, rubella, and Hemophilus influenzae b (Hib), and tetanus toxoid vaccination of pregnant women, have contributed importantly to reducing mortality in children under five years, from 11.9 million deaths in 1990 to ~7.7 million in 2010, while introductions of pneumococcal conjugate and rotavirus vaccines promise additional significant reductions in mortality from pneumonia and diarrhea, the leading infectious causes of death in the post-neonatal period. Affordable combination vaccines were instrumental to the introduction of Hib antigen to EPI schedules of GAVI-eligible countries - 66 of 72 (92%) in 2009. Their introduction has led to simultaneous improvements in coverage of basic antigens, as well as providing operational savings. Advances in combination vaccines, including presentations that increase convenience and injection safety will improve access and programmatic efficiencies, with incremental reductions in vaccine-preventable deaths. Innovative vaccines and approaches to their delivery could contribute to even further reductions of childhood deaths, including those in the neonatal period, when the majority of deaths in children younger than 5 years old occur. Infections in neonates and infants are not easily prevented by active immunization, due to the short interval between birth and the peak age of risk: within the perinatal or neonatal period for Group B streptococcal (GBS) and hepatitis E viral infections and before six months of life for pertussis, influenza, meningococcal, and respiratory syncytial viral (RSV) infections. Their occurrence and age of onset correlate inversely with levels of specific antibodies in cord blood so, following the example of tetanus toxoid vaccination of pregnant women to prevent neonatal tetanus, so-called maternal vaccination is being investigated as a means to prevent these early infections and deaths. The incidence of early and late onset GBS in developing and developed countries is in the same range as neonatal tetanus in South Asia, ~0.5-1/1000 live births, providing a rationale for vaccination of pregnant women with a novel GBS conjugate vaccine globally. Licensed influenza and pertussis vaccines currently are recommended for administration during pregnancy in many countries to protect the expectant mother but, as has been shown in a pilot study of influenza vaccination, prevention of influenza infection in the baby accrues as an additional benefit. Systematic deployment during pregnancy of these, of licensed multivalent meningococcal conjugate vaccine, and novel hepatitis E vaccine and RSV vaccines in development could help reduce the ~10% of infection-related deaths that still occur in the neonatal period. Other vaccine development targets for infection-related deaths in older children remain. For example, in Africa, non-typhoid salmonella (NTS) infections in children below five years of age occur with an estimated incidence of 1 million yearly cases and approximately 100.000 deaths, peaking in the first two years of life. The lack of commercial incentives to invest in vaccines for these and other neglected tropical diseases is being addressed by many mechanisms, including the Novartis Vaccines Institute for Global Health (NVGH), created in 2008 with the not-for-profit mission of developing effective and affordable vaccines against diseases affecting the world’s most impoverished populations. The first vaccines emerging from this effort are a CRM197 glycoconjugate of the Salmonella typhi Vi antigen, currently in Phase 2 clinical trials in endemic countries, and S. paratyphi A and NTS vaccines. In an initiative to build capacity in developing countries, Novartis Vaccines Academy and Siena University have initiated Master and PhD degree courses in vaccinology, with the objective of training physicians from such countries (18 thus far) in various phases of vaccine development. The goal of sustainable development is being met by graduates who have returned to work in vaccine programs of local government and supranational organizations